Dr Sarah Jarvis

My Weekly’s favourite GP from TV and ra­dio writes for you

Lyme dis­ease has prob­a­bly been around for a long time, but it was only recog­nised about 40 years ago. It’s due to an in­fec­tion from a germ called bor­re­lia, which lives in the guts of small ticks. These ticks are usu­ally around the size of a pin-head, but they can swell up to al­most a cen­time­tre long when they’re full of food. That food is blood, which they suck when they lock onto the skin of their host.

So here’s how the life­cy­cle goes. Ticks hatch from eggs, usu­ally in spring. These de­velop into lar­vae, which latch onto a host (like mice or birds). That’s where they can get in­fected with the bor­re­lia germ. From there they de­velop into “nymphs” and then adult ticks. Both of these can bite hu­mans, al­though they also feed on other mam­mals like mice, rats or deer.

While they’re wait­ing for a host to feed from, they climb onto grass or other veg­e­ta­tion un­til the host brushes past them – they can’t jump or fly. That means you’re most likely to be bit­ten in wood­land and moors like Ex­moor, the Lake District, the North York­shire Moors and Scot­tish High­lands.

If you do get in­fected, the first sign is usu­ally a red “bulls eye” rash that spreads out in a ring from a cen­tral red spot. It can start from 3-30 days af­ter you’re bit­ten, and last for sev­eral weeks. You may feel gen­er­ally poorly and tired, with a fever, mus­cle and joint pain. Not every­one gets the rash, and it’s less com­mon if you catch Lyme dis­ease in the USA. This is called “stage 1 Lyme dis­ease”.

If you’re bit­ten by a tick, you won’t rou­tinely be treated be­cause most ticks don’t carry Lyme dis­ease. But if you get any of these symp­toms, es­pe­cially if you’ve been in a high-risk area for ticks, it’s very im­por­tant to see your GP to get treat­ment with an­tibi­otics. At this early stage, treat­ment usu­ally clears the in­fec­tion and pre­vents later stages of the dis­ease.

Many peo­ple who get stage 1 dis­ease don’t go on to get long term com­pli­ca­tions, even with­out treat­ment. But if you’re not di­ag­nosed and treated at stage 1, you can de­velop more se­vere prob­lems.

Stage 2 dis­ease starts a few weeks or months af­ter you’re bit­ten, with var­i­ous com­bi­na­tions of joint pain, nerve weak­ness, or in­flam­ma­tion of the brain, brain cov­er­ing (menin­gi­tis) or heart. Later still, it can cause con­fu­sion, mood changes, or mem­ory loss and prob­lems.

There’s con­tro­versy over treat­ment for later stages of Lyme dis­ease. For in­stance, long term an­tibi­otics can cause se­ri­ous side ef­fects, and the ev­i­dence they help is lim­ited. If your GP sus­pects you might have stage 2 or 3 Lyme dis­ease, they’ll re­fer you to a spe­cial­ist team. Most ticks aren’t in­fected with bor­re­lia, and the big­gest risk of Lyme dis­ease comes if a tick is at­tached to your skin for over 24 hours. Sim­ple pre­cau­tions can cut risks: ◆ Tick bites don’t hurt, so it’s es­sen­tial to check when you come in­doors ◆ Most tick bites hap­pen from late spring to au­tumn ◆ Wear long sleeved shirts and socks tucked into trousers ◆ Stick to paths and stay away from long grass ◆ Use a tick re­pel­lent spray ◆ In­vest in fine-toothed tweezers or a tick-re­moval de­vice (from vets). If you find a tick, grip it as close to the skin as you can, and pull away gently.

THE QUICKER YOU RE­MOVE A TICK ONCE YOU’RE BIT­TEN, THE LOWER THE CHANCE OF GET­TING LYME DIS­EASE – CARRY TWEEZERS IN GRASSY AR­EAS!

Next Week: Blood Can­cer

Feel­ing fever­ish?

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Comments

Poor article, doesn't cover co-infections, suggests inadequate short dose of antibiotics will 'cure' and prevent long term infection. Dose isn't as long as life-cycle of the infection. States they can't fly (fails to mention they can be picked up and moved, by birds). No mention of Co-infections (of which there are many). Inadequate advice on how to protect yourself. I would suggest My Weekly need to speak to patients, who know the reality of this disease.

Last tick, found on me, a few weeks ago; after half an hour in my garden; in a busy town, in Bedfordshire (NOT in the countryside).